Cantilevered suspension sling

ABSTRACT

An arm sling includes a semi-rigid trough which partially encircles and supports a patient&#39;s forearm, wrist, and hand. A yoke is connected to the sides of the trough at a location away from the distal end. An adjustable-length strap extends upward from the yoke over the front of the patient&#39;s ipsilateral shoulder, diagonally across the patient&#39;s back, and transversely across the front of the patient&#39;s body to an attachment point on the trough near the patient&#39;s elbow. An elbow piece adjustably fixed to the trough accommodates various elbow angles and arm widths. The yoke supports the patient&#39;s forearm, wrist, and hand in a cantilevered fashion at various elevations, while not interfering appreciably with lateral movement of the distal end of the trough and rotation of the patient&#39;s upper arm at the shoulder joint.

This is a continuation of application Ser. No. 394,445 filed July 1,1982, now U.S. Pat. No. 4,497,316.

BACKGROUND OF THE INVENTION

1. Field of the Invention

This invention relates to medical devices and, more particularly, to armslings and methods of supporting a patient's arm.

2. Prior Art

Previously, a variety of general-purpose arm slings have been available.These slings include those having a soft, very flexible fabric envelope,or closed trough, which surrounds and provides some support to thepatient's forearm. In some cases, slings of this design prevent easyaccess to the patient's arm for theraputic purposes. To provide supportto the distal end of the patient's forearm, that is, the wrist and hand,this type of sling is supported by a strap attached near the distal endof the fabric envelope and extending around the patient's neck. Theproximal portion of the supporting strap for a flexible envelopecontinues over or behind the shoulder of the arm being supported, thatis, the ipsilateral shoulder. In such an arrangement the weight beingsupported often presses on the side or back of the neck of theindividual. Moreover, the result is that the patient's arm extendsacross the front of the patients chest, rotation of the patient's upperarm at the shoulder joint is severely restricted, and elevation of thedistal end of the patient's arm is difficult and uncomfortable. That is,if the strap is tightened to elevate the patient's hand and wrist, thearm is pulled even more tightly to the chest. The height of handelevation is limited by how tightly the strap can be made around theneck, how closely the trough can be brought to the neck, and whether ornot the distal end of the flexible envelope collapses in the process ofelevation, thus allowing the hand and wrist to droop.

Examples of various types of arm slings having soft, flexible envelopesand/or prior methods of suspension, are disclosed in U.S. Pat. Nos.980,464; 3,103,216; 3,433,221; 4,232,664; and 4,285,337.

Specific apparatus for rigidly fixing a patient's wrist and hand inposition on a relatively rigid forearm supporting member are disclosedin U.S. Pat. Nos. 3,815,588 and 4,214,579, both of which apparatusinclude support straps extending over the patient's opposite, that is,contralateral, shoulder, which prevents rotation of the patient's upperarm at the shoulder joint.

A variety of arm sling positions are desired depending upon thepatient's particular injury or disability; so that an arm sling whichprovides for a wide range of positions depending upon the needs of aparticular patient is very desirable. These positions include one inwhich the upper arm is substantially vertical while the forearm issubstantially horizontal and extends across the patient's lower chest.Another position is one in which the upper arm is still vertical but theforearm is elevated from the elbow at approximately 45 degrees andextends across the front of the patient's chest, keeping the patient'shand above the heart to prevent edema.

Some prior art slings include an elbow pocket to help support the armand to keep the patient's arm in the fabric envelope when the forearm iselevated. Slings which have a soft, fabric envelope do not alwaysadequately support the patient's hand and wrist, especially when theforearm is elevated, since the flexible envelope tends to telescopedownward along the forearm. While others do provide support, they do soby rigidly holding the patient's hand in position with a strap. In somecases rigidly holding the hand may perhaps be necessary, but for othercases requiring support only, these slings may be very uncomfortable.

SUMMARY OF THE INVENTION

This invention provides an arm sling which gives substantial support toa patient's elbow, forearm, wrist, and hand without rigidly fixing thepatient's hand or wrist in position. The invention permits easy accessto the patient's arm while facilitating elevation of the patient'sforearm to a number of positions, and at the same time allowing rotationof the patient's upper arm at the shoulder joint.

In accordance with the invention, an improved method and a versatileapparatus for an arm sling is disclosed. The sling includes a semi-rigidor rigid arm support member, which is formed according to one aspect ofthe invention, from a sheet of flexible plastic material, cardboard, orthe like. The arm support member is formed into a trough for supportingthe patient's elbow at the proximate end of the trough, and thepatient's wrist and forearm at the distal end thereof. The middleportion of the trough supports and partially encircles the patient'sforearm, leaving the top of the trough open for easy access. The ends ofan adjustable strap are coupled respectively to the middle portion ofthe arm support member, that is, away from the distal end of the troughand to a point on the arm support member near the patient's elbow at theproximate end of the trough. The strap extends from the middle portionof the trough, over the patient's ipsilateral shoulder, downwardlyacross the patient's back, and across the front of the patient's upperbody to a point on the arm support member near the patient's elbow. Thestrap thus suspends the patient's arm in the trough formed from thesemi-rigid arm support member, in a cantilevered fashion. Adjustment ofthe strap length provides for elevation of the distal end of thepatient's forearm (including his wrist and hand) to a variety ofpositions. However, the invention leaves such distal end of the troughrelatively free for lateral movement, and allows rotation of thepatient's upper arm at the shoulder joint.

According to one aspect of the invention, the arm support member has apair of side portions, to which a yoke is connected. The adjustablestrap is then connected to the yoke to support the patient's forearm ina cantilevered fashion, that is, near the middle of the trough and awayfrom the distal end of the trough, while the relatively rigid distal endof the trough provides support for the patient's wrist and hand.

According to another aspect of the invention, an elbow piece is providedfor the arm support member. It should be apparent that one of a numberof elbow angles is required when using the invention. With this in mind,adjustable means are provided for fixing the elbow piece in position ata particular angle with respect to the arm support member. In apreferred embodiment, these adjustable means include pressure-sensitiveengaging means, such as those available under the tradename "Velcro",for adjustably fixing the angle of the elbow piece relative to thetrough, and also for adjusting the width of the trough to accommodatethe width of the patient's arm.

The cantilevered suspension of the semi-rigid arm trough thus permitsthe distal end of a patient's arm to be comfortably supported at a pointaway from the distal end of the trough and provides unencumbered accessto the patient's arm. In addition, this invention permits the patient'sarm to be elevated to any desired position while still permittingrotation of the arm at the shoulder joint as well as allowing freelateral movement of the arm from a position having the arm extendingdirectly across the patient's body to a position with the arm extendingforward and away from the body. The adjustable aspect of the elbow piecealso facilitates and improves patient care and comfort.

BRIEF DESCRIPTION OF THE DRAWING

For a more complete understanding of the invention, reference is made tothe drawings which form a part of this specification in which:

FIG. 1 is a front view of a patient wearing a sling according to theinvention;

FIG. 2 is a perspective view of a sling with the elements thereof shownarranged for use;

FIG. 3 is a plan view of a one-piece arm support member according to theinvention;

FIG. 4 is a partially cutaway view of a yoke and an adjustable supportstrap according to the invention;

FIG. 5 is a front view of a patient wearing a sling according to theinvention with the patient's forearm elevated 45 degrees and extendingacross the patient's chest; and

FIG. 6 is a front view of a patient wearing a sling in the elevatedposition of FIG. 5 but with the arm laterally moved away from thepatient's chest.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT

Reference is now made in detail to a preferred embodiment of theapparatus of the invention illustrated in the accompanying drawings,which incorporates the best mode contemplated by the inventor at thetime of filing this patent application, of practicing the method andapparatus of the invention.

Referring to the drawings, FIG. 1 shows a sling assembly 10 supportingthe arm 12 of a typical patient 14 in one of a number of positions. Anarm support member 16 is formed into a trough 17 which partiallyencircles and supports the patient's forearm 18. Most desirably, supportmember 16 is a sheet of a semi-rigid (slightly flexible) material, suchas of a cardboard or of a vinyl, polyethelene or polypropolene plastic.However, from the broad standpoint it could be of a rigid materialformed into a desired shape for supporting a patient's arm.

The distal end of the patient's forearm 18, that is, the patient's wrist20 and hand 22, is supported by the distal end 24 of the trough 17. Thepatient's elbow 26 is supported by the trough 17 at its proximate end28. The middle portion 30 of the trough comfortably supports andpartially encircles the patient'forearm 18, leaving the area above thepatient's arm open to permit easy access for (and to) theraputic devicesand the like. FIG. 2 shows on a somewhat larger scale, the trough 17formed by the arm support member 16.

FIGS. 1 and 2 also show a support strap 34 coupled by means of a yokestrap at one end 36 to the middle portion 30 of the arm support member16, that is, away from the distal end 24. A major advantage of couplingthe support strap 34 at this point is that the patient's wrist and handare supported in a cantilevered fashion, thereby enabling the freedomand flexibility discussed previously. Another advantage, apparent fromFIG. 1, is that the support means for the trough 17 does not interferewith access to the patient's arm or appliances thereon.

The strap 34 extends, as shown, over the patient's ipsilateral shoulder38, that is, the shoulder to which the arm under treatment is connected,diagonally downwardly across the patient's back 40 and then around andacross the front 42 of the patient's upper body. FIG. 2 shows the otherend 44 of the strap 34 coupled to the arm support member 16 at theproximate end 28 of the trough 17 near the patient's elbow 26. The strap34 thus provides support to the patient's forearm 18, as well as to thewrist 20 and hand 22, by suspending the semi-rigid arm support member 16in a cantilevered fashion from the patient's shoulder 38. The strap isadjustable in length so that the distal end of the patient's arm can beelevated by the trough 17 to a desired, predetermined position asrequired. When it is adjusted by, for example, tightening, the patient'selbow is brought forward as an anchor point and the trough issimultaneously elevated. The weight of the extremity is distributed bythe strap diagonally across the back of the patient.

An arc 46 is included in FIG. 1, indicating that the distal end of thepatient's forearm, which includes the wrist 20 and hand 22, is free tomove laterally and that the patient's vertically-oriented upper arm 48can rotate at the shoulder joint 50 while the patient's elbow 26 remainsin the same relative location.

FIGS. 1 and 2 show a yoke member, in this preferred embodiment a thinstrap 54, having ends 56, 58 thereof attached to respective ones of apair of side portions, or lateral flaps 60, 62 extending from the armsupport member 16 to form opposite sides of the trough 16. The end 36 ofthe strap 34 is connected to the yoke strap 54 and, as previouslydescribed, supports the patient's forearm away from its distal end in acantilevered fashion, leaving the distal end 24 of the trough 17 freefrom support means while still providing comfortable support for thepatient's forearm, wrist, and hand. It should be noted that the use ofyoke strap 54 enhances access to the patient's forearm by elevating theend 36 of the strap 34 from the trough.

FIGS. 1 and 2 show an elbow piece 68 coupled to the arm support member16. Means for adjustably fixing the elbow piece 68 at various angleswith respect to the trough 17 are provided by a pressure-sensitiveengaging means. That is, the straps 70, 72 having portions thereonavailable under the tradename "Velcro" providing hooks which engagelooped portions of corresponding strips 74, 76 fixed to the insidesurface of the trough 17. The straps 70, 72 extend through correspondingelongated slots 80, 82 formed in the lateral flaps 60, 62. The straps70, 72 permit the angle of the elbow piece 68 to be adjusted toaccommodate various angles of the patient's elbow, which anglescorrespond to various elevations of the distal end of the patient'sforearm. The straps 70, 72 also permit the proximate end 28 of thetrough 17 to be adjusted in width to accommodate the width of thepatient's arm. The elbow piece 68 provides support to the patient'selbow 26 and upper arm 48.

FIG. 3 illustrates in a plan a preferred embodiment of the semi-rigidarm support member, formed with a symmetrically shaped sheet of plasticmaterial, cardboard, or other suitable material have semi-rigid,flexible characteristics. The arm support member 16 includes the lateralflaps 60, 62 which form the sides for the trough 17. The elongated slots80, 82 are formed in the flaps 60, 62 and the strips 74, 76 are attachedas shown to permit the straps 70, 72, each riveted at one end to thesides of the elbow piece 68, to fix the elbow piece 68 in one of anumber of positions. Eyeletted holes 84, 86 are provided on therespective lateral flaps 60, 62, through which the respective ends 56,58 of the yoke strap 54 extend and are tied, knotted, or otherwiseconnected for attachment of the yoke strap 54 to the arm support member16.

FIG. 4 shows a fabric strap 34 having attached at one end 36 the yokestrap 54. At the other end 44 is a strap length adjustment buckle 90 anda strap fastener snaphook assembly 92 which fastens to a D-ring 93(shown in FIG. 2) fastened adjacent the elbow piece to the arm supportmember 16. By varying the length of the strap 34, the patient's forearmmay be elevated to a number of positions depending upon the patient'sparticular injury or disability. It should be noted that other fasteningstructures, such as "Velcro" tape, can be substituted for the snaphookD-ring combination 92-93.

FIG. 1 shows the patient's forearm in a position extending slightlybelow horizontal with the distal end of the arm being free to be movedlaterally towards and away from the front 42 of the patient's body, asindicated by the arc 46. The patient's upper arm 48 can also rotate inthe shoulder joint 50. The elbow piece 68 is adjusted to accommodate theelbow angle and provide support to the elbow. The strap 34 and yoke 54suspend the arm from the patient's shoulder 38 in a cantileveredfashion, leaving the forearm, and especially the wrist and hand, wellsupported by the trough 17 and easily accessible.

FIG. 5 shows the patient's forearm in a 45 degree elevated positionacross the front 42 of the patient's body. The length to the strap 34 isshortened from that shown in FIG. 1 so that the patient's arm is pulledupward and the elbow piece is adjusted as shown. As the strap 34 isshortened, the patient's elbow is pulled forward and the yoke strap 54pulls upwardly.

FIG. 6 shows the patient's arm in the 45 degree elevated position ofFIG. 5 but with the arm rotated to the front of the patient.

In summary, it should be appreciated that the invention offers anattractive sling means for supporting a patient's arm at a point awayfrom the distal end of the arm, while still providing comfortablesupport to the patient's wrist and hand. This is accomplished with thecantilevered support given to the arm with the semi-rigid arm supportmember depending from the strap provided according to the invention. Theinvention provides freedom to laterally move the distal end of thepatient's arm and rotate the patient's upper arm at the shoulder jointfor all arm elevation positions. The open, unencumbered trough designand the adjustable elbow angle are also attractive features of thisinvention.

Although the invention has been described in connection with onepreferred embodiment, it will be appreciated by those skilled in the artthat the invention is not limited thereto since various changes andmodifications can be made. It is therefore intended that the claimscover any and all such changes and modifications which fall within thetrue spirit and scope of the basic underlying principles disclosed andset forth herein.

What we claim is:
 1. A sling for supporting an arm of a patient,comprising:an arm support member of a semi-rigid or rigid materialproviding a trough for supporting the distal end of a patient's forearmat the distal end of the trough and the patient's elbow at the proximateend of the trough with the middle portion of the trough partiallyencircling and supporting the patient's forearm; and a strap coupled atone end to the middle portion of the arm support member away from thedistal end of the arm support member, and adapted to extend therefromover the ipsilateral shoulder of a patient diagonally downward acrossthe patient's back and across the front of the patient's upper body tobe coupled at the other end thereof to the arm support member near thepatient's elbow, whereby said strap supports the arm support member in acantilevered fashion from the patient's ipsilateral shoulder; said slingfurther comprising an elbow piece coupled to the arm support member andincluding means for adjustably fixing the elbow piece at various angleswith respect to said trough formed by the arm support member toaccommodate various angles of elevation of the distal end of thepatient's forearm relative to the patient's elbow.
 2. The sling of claim1 wherein said strap is adjustable in length for elevation of the distalend of the patient's forearm to a predetermined position whilepermitting lateral movement of the distal end of the trough and rotationof the patient's upper arm at the shoulder joint.
 3. The sling of claim1 or claim 2 wherein said arm support member includes a pair of sideportions forming the sides of the trough and including a yoke memberhaving respective ends thereof attached to one of the pair of sideportions of the semi-rigid arm support member and wherein the strap iscoupled to the yoke to support the patient's forearm in a cantileveredfashion leaving the distal end of the arm support member free fromsupport means.
 4. The sling of claim 1 including pressure-sensitiveengaging means for adjustably fixing the elbow piece at various anglesand for adjusting the width of the trough to accommodate the width ofthe patient's arm.
 5. The sling of claim 1 or claim 2 wherein the armsupport member is a semi-rigid flexible sheet of material adapted tobeing formed in a trough supporting the patient's arm.
 6. An adjustablearm sling for a patient's arm, comprising:a one-piece, arm supportmember having a main body portion as well as lateral side portions andan elbow portion; pressure-sensitive straps extending between the mainbody portion and the elbow portion of the arm support member toadjustably fix the angle therebetween to accommodate the angle of thepatient's elbow and to adjust the main body portion of the arm supportmember to the width of the patient's arm; a yoke having each end thereofattached to one of the lateral side portions near the middle of the armsupport member; and an adjustable strap connected at one end to the yokeand to the other end thereof to the arm support member near thepatient's elbow, said strap extending from the yoke over the patient'sipsilateral shoulder, diagonally across the patient's back, and acrossthe front of the patient's upper body to the arm support member near thepatient's elbow, said strap being adjustable so that the yoke elevatesthe distal end of the patient's arm to a desired position whilepermitting lateral movement of the distal end of the arm support memberand rotation of the patient's upper arm at the shoulder joint andleaving the distal end of the arm support member free from support meanswhile the semi-rigid arm support member provides support for the distalend of the patient's arm.